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All Experience is an Arch by Dick Sainsbury

In his collection of writing about geriatric medicine, older people and ageing, retired geriatric physician Dick Sainsbury pays tribute to the pleasure that both geriatric medicine and English literature have given him.

He hopes his book will not be seen as ‘a disorganized mishmash' but as ‘an assortment of chocolates from which people can collect their choice. No fighting over the coffee cremes, please!’ he writes.

I will never say no to a chocolate! So, I dived right in to sample what was on offer. In the first part of the book are his recollections on the spirit and philosophy of geriatric medicine with some history; some vignettes, case histories and teaching points.

Although he is primarily speaking to health professionals and medical students he writes in very accessible language and there is also plenty of food for thought in here for anyone who is interested in ageing, those who have ageing relations or friends or are old themselves.

His advice that we must continue to find ways to make hospitals user friendly, and that the patients’ choice is what matters really resonated with me.

And the way he makes a compelling case for diagnosis and treatment- not disposal.

“Historically, all too often, the function of geriatric medicine service has been viewed as the means to remove the ‘unwanted’ old people from acute services or their homes rather than provide an opinion about how the old person’s health function and independence could be improved.”

He feels that where possible old people should be allowed to and be supported to continue to live at home even when their house keeping skills are somewhat lacking.

“A person’s liberty is their most precious attribute. We have no right to interfere in the way a competent person chooses to live. If we condemned every ramshackle untidy house, then a very large number of the student flats in North Dunedin would be in trouble.”

Many of the geriatric patients in this book were in a bad way, suffering from dementia, delirious, depressed or terminally ill. This made me feel rather despondent. But old age does not have to be like that.

Dick Sainsbury himself is a living example of how the last part of the journey can be a very fulfilling time of your life. After very unexpectedly suffering a cardiac arrest while playing cricket, which required a coronary artery bypass graft, he recovered and has been blessed with valuable extra time during which he has remarried, enjoyed his family life, served on boards, taken up croquet, and started to learn French.

Being of a literary bent, the last part of his book was my favourite, and I took much delight in dipping into each short chapter.

Including a literary section in his book may seem somewhat curious but Dick Sainsbury points out that the study of old people in literary works can aid geriatricians in their understanding of ageing. He himself has a great love for the great classics of English literature and interprets them from his unique perspective.

Thomas Hardy is his favourite author despite his sometimes gloominess, and he has devoted a chapter to him titled Doctors, Conjurers and Quacks. Included also is a paper he co-authored with two speech-language therapists in which they have done an analysis of the neurological speech deficits as plot devices in novels by George Eliot, Emile Zola, Charles Dickens, and Leo Tolstoy. His many examples of noble elders in Wordsworth’s poetry are very touching.

If I should ever find myself in a geriatric ward, and being old this is a possibility, a doctor with a literary bent who can have a bedside chat about English literature, now that would be the best kind of medicine!

Reviewer: Lyn Potter

Quentin Wilson Publishing


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